opiates

Introduction to Opiates and Narcotics

  • Today's lecture focuses on a new class of drugs: opiates, often associated with addiction.

  • Opiates are formally referred to as narcotics, derived from the Greek word "narc," which means numbness or stupor.

  • Narcotics have historically been associated with being criminalized, such as marijuana wrongly categorized as a narcotic.

Opiates: Types and Sources

Definition and Characteristics

  • Opiates are primarily known for their analgesic properties, used to relieve pain.

  • Two main categories: naturally occurring opiates and synthetic/non-naturally occurring opiates.

Naturally Occurring Opiates

  • Derived from the poppy plant, Papaver somniferum (the poppy that brings sleep).

  • The plant is an annual, grows to a height of 3-4 feet with multicolored flowers.

  • Poppy seeds are edible, while the seeds can contain trace amounts of opiates if consumed.

Notable Characteristics of the Poppy Plant

  • Distinction between Papaver somniferum and other garden varieties, which do not contain opiates.

  • Images showcase the opium poppy's beauty and characteristics, including flower petals and seed capsules.

History of Opiate Use

Early Evidence

  • Evidence of opium use dates back to 2000 BC, depicted in artifacts showing scraping and collecting processes.

  • Indigenous to the Middle East, particularly Afghanistan, Turkey, India, and Pakistan.

  • Spread to Europe during the Crusades in the 11th-12th centuries.

Medical Preparation

  • Initial medical preparation: laudanum, introduced in the early 1500s, remained in use until the early 1900s.

  • Opium was predominantly smoked or inhaled; direct combustion is avoided to preserve its properties.

The Process of Cultivating Opium

Harvesting Technique

  • Workers make vertical slits in seed capsules for harvesting opium, which oxidizes and turns into a brown gummy substance.

  • Images display the milky exudate and the subsequent gummy opium.

Chemical Constituents of Opium

Main Components

  • Morphine: Naturally occurring opiate used for pain relief.

  • Codeine: Also naturally occurring, primarily a cough suppressant.

  • Thebane: Not an active opiate but precursor for producing oxycodone, a widely abused prescription substance like OxyContin.

Geography of Opium Cultivation

  • Cultivated in Southeast Asia, Afghanistan, Iran, and even Mexico and South America.

Timeline of Opiate Isolation and Use

Key Historical Figures and Events

  • Early 1800s: German chemist Friedrich Sertürner isolates morphine, naming it after Morpheus, the Greek god of dreams.

  • Mid-1800s: Alexander Wood develops the syringe, increasing morphine's medical use and potential for abuse.

Opiate Addiction During Wars

  • Extensive morphine use in American Civil War (1861-1865) led to addiction termed "soldier's disease."

Emergence of Patent Medicines

Early Legislation and Public Response

  • In the late 1800s, many drugs, including opiates, were common in tonics sold as medical preparations.

  • Common examples include Mrs. Winslow's Soothing Syrup, marketed for infants during teething.

20th Century Changes

  • Shift toward prohibition and criminalization: 1908 Opium Act in Canada prohibited opium importation, manufacture, or sale for non-medical purposes.

  • Possession was not initially criminalized, but further acts in 1911 made possession a crime.

The Prohibition Era

Social and Cultural Impact

  • Prohibition intensified moral, legal, and medical debates on drug use and addiction.

  • Misguided belief that addiction was a result of weak will rather than a medical issue.

Legislative Developments

  • 1929 Opium and Narcotic Act eliminated the ability of doctors to prescribe maintenance doses for opiate addiction.

  • Introduction of rigid enforcement laws like the writ of assistance, allowing open-ended warrants for police searches.

Contemporary Opiate Landscape

Major Opiates and Their Potency

Naturally Occurring Opiates

  • Morphine: Primary choice for pain relief.

  • Codeine: Good for treating cough; availability restricted after misuse.

Synthetic Opiates

  • Heroin (diacetylmorphine): Developed by C. R. Alder Wright, more lipid-soluble than morphine; initially marketed as a cough remedy.

  • Fentanyl: Developed in 1960s, potent medical opiate used in severe pain cases.

  • Derivatives of fentanyl: More lethal than heroin, often found mixed with other drugs.

Illicit Drugs

  • Crocodile: A codeine derivative known for causing severe skin effects.

  • Isotonitazene (ISO): A fentanyl analog found on the streets.

  • Kratom: Natural herb with opioid-like effects, also causes dependence and withdrawal.

Prescriptions and Their Risks

Opiates in Prescription Medicine

Commonly Prescribed Opiates

  • Oxycodone: Main ingredient in OxyContin and available in various formulations.

  • Hydrocodone (Vicodin): Derived from codeine; less potent than oxycodone.

  • Oxymorphone (Opana) and Hydromorphone (Dilaudid): Both have high abuse potential and are commonly misused.

Overdose and Reversal Strategies

Opiate Antagonists

  • Naloxone (NARCAN): Used to reverse overdoses; shorter duration of action requiring multiple doses.

  • Naltrexone: Longer-acting antagonist used in treating alcohol use disorder by blocking opiate receptors.

Conclusion

  • Awareness of opiate history, current drugs, and prevention strategies is essential in addressing both medical uses and the ongoing addiction crisis.

  • Future discussions will delve into harm reduction strategies and the complexities surrounding opiate use and legislation.